Mental health in the workplace has been a significant focus for several years now, but most of us can still remember a time when mental health wasn’t a regular topic of conversation or high on a list of wellbeing priorities.
In the UK, the spotlight was firmly targeted on mental health in the workplace when Paul Farmer and Lord Dennis Stevenson issued their Prime Ministerial sponsored report, Thriving at Work, in October 2017. This report provided empirical evidence of both the personal and economic impact of mental health issues among the UK workforce.
In addition, it helped improve general awareness of the differences between mental illness and mental health issues; the former being specific clinically diagnosed ill health, and the latter more common issues that up to 15% of the UK workforce suffer from at any one time.¹
Thriving at Work indicated that mental health issues cost UK employers up to £42bn.¹ Additional research by Deloitte, who worked on the statistics for Thriving at Work, estimated this cost at over £43bn in 2018.² The total cost to the UK economy is about £99bn.¹ These mental health issues aren’t confined to the UK. WHO research shows that mental health issues (depression/anxiety) cost the world economy US$1 trillion in 12 months (2018-19).³
With these types of figures being bandied about, it’s not surprising that businesses are looking to invest in interventions that will help both them and their employees meet the challenges of mental health issues – improving both the bottom line and personal wellbeing. But what is the right course of action?
For many employers mental wellbeing in the workplace is dealt with via one or more, generally reactive, initiatives: mental health benefits within health insurance, employee assistance programmes, mental health champions or mental health first aiders.
Each of these initiatives has considerable merits in helping employees deal with mental health issues and each approaches the issue from a different angle. However, there is a commonality in that each of these interventions deals with the mental health issue when it is already becoming a problem: reacting to the situation rather than proactively looking to prevent the issue.
Health insurers have dramatically improved mental health provision over the last five years, to the extent that it is now being raised to a similar level as physical health benefits and is often promoted by providers as one of their key selling points.
Early intervention is viewed as key to recovery, so many insurers are introducing helplines and direct access to mental health care services to reduce any bottlenecks in accessing advice/treatment. However, even with these improvements, there is still the problem that the employee needs to already be suffering from a problem, recognise that fact and be willing/able to seek help before they can be directed to appropriate assistance and treatment.
Employee assistance programmes
EAPs can trace their roots to the US back in the 1940s. They provide confidential help and in some cases face-to-face counselling. They provide help on a range of issues that may be causing the employee stress or anxiety both in work and in their domestic life.
Although EAPs can be arranged as a standalone benefit, they are also often incorporated into other risk policies such as group life insurance, group income protection and group health insurance.
Once again, EAPs tend to be reactive – the employee is already feeling the pressure of the stressor. In addition, although EAPs are very useful as part of an overall mental health strategy, there are limitations:
- Limits on support:
Although most EAPs will offer counselling sessions, they are often limited to six or eight sessions. They provide quick, first step assistance, but on their own they may not be a solution. They will often be limited to providing signposting to further help via health insurance or community health services.
- Singular issue approach:
When employees have problems, there could be several issues in play: financial worries, relationship difficulties, stress/anxiety at work. Each of these matters may be interlinked and ‘feeding off each other’. Many EAPs work almost in silos, tackling the individual issues rather than a joined-up approach. This makes dealing with the tangle of problems difficult.
Although EAPs provide a valuable resource, usage can be very low. In the UK the average usage is 5% of employees.4 In North America the figure is higher but at 6.9%5 is still not significant. There are likely to be several reasons for this – lack of promotion of the service, perceived issues around confidentially, feeling that the issue isn’t appropriate for EAP help.
Mental health champions/mental health first aid
Mental health first aid (MHFA) training was initially introduced in Australia back in 2000. Training has now spread globally and by 2016 over 1.7 million people had been trained in MHFA worldwide. As with EAPs, the potential impact of MHFA relies heavily on employees being willing to approach the designated colleague with their issues.
The other potential difficulty is selecting the right people to train in MHFA or be mental health champions. Often this is arranged by asking for volunteers or, alternatively, using supervisory functions. Neither way is ideal because the individuals involved may not be the best candidates for the role, may have their own issues to deal with and colleagues might have difficulty confiding in them.
A new approach?
Just to clarify, each of the interventions above is a valuable tool in tackling mental health issues, but everyone in this area of workplace wellbeing is on a steep learning curve, so fully understanding the effect of these benefits in specific situations is difficult.
Having investigated the downside of the ‘traditional’ approach, what might the alternatives look like? Two of the key issues mentioned above are:
- Communication/employee awareness – often mental health interventions don’t deliver the results expected because employees don’t know they are available. Communication is key. We should remember that at a time of crisis, an employee might not remember where they put the details of the EAP and/or remember the name of the colleague who is the MHFA.
- Willingness to seek help and discuss the issues – the taboos around mental health issues are still prevalent and will often result in employees ‘suffering in silence’ rather than seeking help in the workplace.
Addressing these issues, we need to look at interventions that proactively talk directly to employees. The objective should be to equip them with skills so they can deal with their own issues and/or be guided to seek help both from inside and outside the workplace. A potential solution would be to introduce business-wide mental health training via an online platform.
This training can:
- Ensure all staff are trained in respect of mental health awareness
- Give direct access to all staff in respect of where to find help if needed
- Provide specific education for managers/supervisors so they can recognise potential issues in colleagues and signpost them to help
- Direct employees to online resources providing information and guidance in relation to mental health issues
The key benefits of this approach are:
- All employees can be trained to the same standard. No need to look for mental health champions or MHFA volunteers. All staff are provided with awareness of mental health, knowledge of how mental health issues manifest themselves, and what to do if they or a colleague appears to have mental health issues
- Employees are provided with confidential access to resources/guidance so they can self-care and seek help – this avoids the issue of talking to colleagues about sensitive matters
- It is proactive, so employees are trained whether they have issues at the moment or not
- It is ongoing, not a one-off hit. In addition, subject to devices/ability to log in, it is constantly available 24/7. Employees can use the information resources at any time and the mental health training is available for refresher sessions
- Although the information around the programme is confidential, the company HR function receives management information of progress through the training modules so they can prompt employees to ensure everyone is trained
Like EAPs and MHFA etc., this online training isn’t a panacea to mental wellbeing in the workplace. However, as a foundation for a mental wellbeing strategy it can provide employees with significant training and personal knowledge that will ensure they aren’t in the dark about the subject. Then, if they or a colleague present with an issue, they can self-care using the resources provided to them by their employer (EAPs etc.) and/or the State.
Ed Watling is the healthcare business development manager at Mattioli Woods
 Thriving at Work, Stevenson & Farmer, October 2017
 UKEAPA – Research Report, The Evolution of Employee Assistance November 2016